The impact of the COVID-19 pandemic on the psychological well-being of caregivers of people with dementia or Mild Cognitive Impairment: A systematic review and meta-analysis

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09–0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05–2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42–4.95; p < 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13–0.56; p = 0.001; I2 = 54.1%) (p < 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers’ psychological well-being is assessed and supported, to benefit both themselves and those for whom they care.</p

Results of MRI and SPECT examinations of the proband.

<p>Magnetic Resonance Imaging revealed marked cortical and subcortical atrophy within both occipital and parietal lobes bilaterally. The atrophy was less pronounced in the frontal and temporal lobes, and the hippocampal structures of the temporal lobes were mostly preserved. Single Photon Emission Computed Tomography demonstrated severe hypoperfusion within the parietal, occipital and temporal lobes bilaterally.</p

Results of MRI and SPECT examination of a control subject.

<p>Magnetic Resonance Imaging and Single Photon Emission Computed Tomography demonstrating the normal scans of a control, age-matched patient with no signs of any neurodegenerative disorder.</p

Analysis of visuospatial dysfunction of the patient.

<p>Patient's drawings in the context of drawings by a patient with semantic dementia. (SD) scoring 19 in MMSE were presented. A) flowers drawn by the patients from memory: A1) PCA patient, A2) SD patient; B) model, C) patients' copy: C1) PCA patient, C2) SD patient. Copying pictures and drawing to command indicated severe optic ataxia and partial simultanognosia. The test was performed at first neuropsychological assessment. During the second assessment (six months later) the patient was unable to draw even simple patterns and presented with complete simultanognosia.</p

Frequency of dementia patients registered at specialist (memory clinic) and primary care units in SveDem during 2007–2012 (n = 28722).

<p>Frequency of dementia patients registered at specialist (memory clinic) and primary care units in SveDem during 2007–2012 (n = 28722).</p

Organisational structure of SveDem.

<p>Organisational structure of SveDem.</p

Characteristics of the whole population of dementia patients registered in SveDem during 2007–2012 (n = 28722).

<p>Characteristics of the whole population of dementia patients registered in SveDem during 2007–2012 (n = 28722).</p

Frequency of different types of dementia in the whole population registered in SveDem during 2007–2012 (n = 28722).

<p>Frequency of different types of dementia in the whole population registered in SveDem during 2007–2012 (n = 28722).</p